
<!DOCTYPE html>
<html lang="zh-CN">
<head>
    <meta charset="UTF-8"/>
    <meta content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=1" name="viewport" />
    <meta http-equiv="content-script-type" content="text/javascript">
    <meta name="format-detection" content="telephone=no" />
    <!-- uc强制竖屏 -->
    <meta name="screen-orientation" content="portrait">
    <!-- QQ强制竖屏 -->
    <meta name="x5-orientation" content="portrait">
            <link rel="shortcut icon" href="/favicon.ico">
            <meta http-equiv="Cache-Control" content="no-cache, no-store, must-revalidate" />
        <meta http-equiv="Pragma" content="no-cache" />
        <meta http-equiv="Expires" content="0" />
    <title>分销申请</title>
    <link rel="stylesheet"href="statics/mobile/css/style.css?v=2017093059333655645712">


    <link rel="stylesheet"href="statics/mobile/css/User/addressManage.css?v=2017093059333655645712">
    <link rel="stylesheet"href="statics/mobile/css/Agent/dist_apply.css?v=2017093059333655645712">
    <style>
        .addurl_con>ul li.liArea{
            padding: 13px 0;
            height: auto;
        }
        .addurl_con>ul li.liArea label{
            line-height: 18px;
        }
        #apply_notes{
            width: 60%;
            height: 54px;
            padding: 3px;
            border: 1px solid #ccc;
        }
    </style>

</head>

<body style="">
<div class="membersbox pad50">


    <div class="apply_headimg">
        <img src="statics/mobile/images/apply_head.jpg" width="100%" height="125px;"alt="">
    </div>
    <div class="apply_wrapper">
        <section class="apply_tip">欢迎加入<span></span>，请填写申请信息！</section>
		<form action="?con=agent&act=apply" method="post" class="apply_form" id="form1">
		  <input type="hidden" name="commit" value="1"/>
            <section class="addurl_con">
                <ul>
                    <li class="clearfix">
                        <label><b class="colorRed">* </b>申请人：</label>
                        <input type="text" name="agent_name" id="agent_name" placeholder="请输入您的真实姓名" value="" class="textw" data-require="1">
                    </li>
					<li class="clearfix">
                            <label><b class="colorRed">* </b>邀请码：</label>
                            <input type="text" name="invite_mobile" id="invite_mobile" placeholder="请输入推荐人手机号" value="" class="textw">
                        </li>
					<li class="clearfix">
                            <label><b class="colorRed">* </b>手机号码：</label>
                            <input type="text" name="mobile" id="mobile" value="" placeholder="请输入您的手机号码" class="textw" data-require="1">
                        </li>                    
						<li class="clearfix">
                            <label><b class="colorRed">* </b>微信号：</label>
                            <input type="text" name="weixin_account" id="weixin_account" placeholder="请输入您的微信号" value="" class="textw" data-require="1">
                        </li>
                        <li class="clearfix">
                            <label><b class="colorRed">* </b>选择地区：</label>
                            <a href="javascript:;" class="selectAddress j-selectAddress"><em>点击选择</em></a>
                            <input type="hidden" name="province_id" value="" placeholder="请填写您的地址" data-require="1">
                            <input type="hidden" name="city_id" value="">
                            <input type="hidden" name="area_id" value="">
                            <input type="hidden" name="town_id" value="">
                        </li>
                        <li class="clearfix">
                            <label><b class="colorRed">* </b>详细地址：</label><input type="text" name="address" id="address" value="" placeholder="请输入您的详细地址" class="textw" data-require="1">
                        </li>                    
						<li class="clearfix liArea">
                            <label> <b class="colorRed">* </b>备注：</label>
                            <textarea type="text" name="apply_notes" id="apply_notes" maxlength="225" placeholder="请填写备注。" value="" class="textw" data-require="1"></textarea>
                        </li>                
				</ul>
				<!--<div class="apply_agreement"><section style="word-wrap: break-word;word-break:break-all;"><input type="checkbox" name="need_apply_agreement"/>分销商协议</section></div>-->

                <section class="mlogin_but"><a href="javascript:;" class="J-addApply">确定</a></section>

                <!--section class="mlogin_but" style="margin-top:10px;"><a class="call J-call" href="javascript:;">取消</a></section-->
            </section>
        </form>
            </div>

      <?php include VIEWS_PATH."bottom.php";?>
    <b id="htmlReplace-navCart"></b>
</div>

<script type="text/j-template" id="j-addrM-selectArea-province" >
    <section class="adrM adrM-selectArea adrM-selectArea-province hide">
	    <header class="top">
	        <a href="javascript:;" class="btn-backArrow j-addrM-back">
	            <i class="icon-back"></i>
	        </a>
	        <span>请选择省份</span>
	    </header>

	    <section class="content">
	        <ul class="area-list">
	        	<%_.each(data,function(item){%>
		            <li>
		                <a href="javascript:;" data-provinceid="<%=item.province_id%>"><%=item.province_name%></a>
		            </li>
	            <%})%>
	        </ul>
	    </section>
	</section>
</script>
<!-- end 选择收货地区-省 -->

<script type="text/j-template" id="j-addrM-selectArea-city" >
    <section class="adrM adrM-selectArea adrM-selectArea-city hide">
	    <header class="top">
	        <a href="javascript:;" class="btn-backArrow j-addrM-back">
	            <i class="icon-back"></i>
	        </a>
	        <span>请选择城市</span>
	    </header>

	    <section class="content">
	        <ul class="area-list">
	        	<%_.each(data,function(item){%>
		            <li>
		                <a href="javascript:;" data-cityid="<%=item.city_id%>"><%=item.city_name%></a>
		            </li>
	            <%})%>
	        </ul>
	    </section>
	</section>
</script>
<!-- end 选择收货地区-市 -->

<script type="text/j-template" id="j-addrM-selectArea-area" >
    <section class="adrM adrM-selectArea adrM-selectArea-area hide">
	    <header class="top">
	        <a href="javascript:;" class="btn-backArrow j-addrM-back">
	            <i class="icon-back"></i>
	        </a>
	        <span>请选择区域</span>
	    </header>

	    <section class="content">
	        <ul class="area-list">
	        	<%_.each(data,function(item){%>
		            <li>
		                <a href="javascript:;"  data-areaid="<%=item.area_id%>"><%=item.area_name%></a>
		            </li>
	            <%})%>
	        </ul>
	    </section>
	</section>
</script>
<!-- end 选择收货地区-区 -->

<script type="text/j-template" id="j-addrM-selectArea-street" >
    <section class="adrM adrM-selectArea adrM-selectArea-street hide">
	    <header class="top">
	        <a href="javascript:;" class="btn-backArrow j-addrM-back">
	            <i class="icon-back"></i>
	        </a>
	        <span>请选择街道</span>
	    </header>

	    <section class="content">
	        <ul class="area-list">
	        	<%_.each(data,function(item){%>
		            <li>
		                <a href="javascript:;" class="noArrow" data-streetid="<%=item.town_id%>"><%=item.town_name%></a>
		            </li>
	            <%})%>
	        </ul>
	    </section>
	</section>
</script>
<!-- end 选择收货街道 -->

<?php include VIEWS_PATH."footer.php";?>

<script src="statics/mobile/js/dist/User/addressManage.js?v=2017093059333655645712"></script>
<script src="statics/mobile/js/dist/Agent/agentApply.js?v=2017093059333655645712"></script>


<!--在线客服 -->

</body>
</html>
<!-- 20170105 -->
